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FIBROIDS, UTERINE
MYOMA
A tumour composed of muscular tissue is called a myoma. Such tumours may consist of striped fibres, but they are extremely rare, while tumours composed of unstriped fibres are among the commonest found in the body. To them the term myomata is applied.
Naturally, they are found where unstriped muscle is in greatest abundance, namely, in the womb, and they may also arise in the wall of the intestine, into the structure of which unstriped muscle largely enters. The cells composing them are, in the main, spindle-shaped, with definite nuclei, following, in fact, the structure of unstriped muscular tissue generally. But a large proportion of the fibres are very similar to those entering into the formation of white fibrous tissue (q.v). Hence the tumours are often known as fibro-myomata, or, more shortly, fibroids.
Myomata, as a class, are not malignant, that is, they do not tend to recur after removal or to be disseminated throughout the body.
Fibroid tumour or fibro-myoma, is the commonest type of tumour to develop in the womb. It arises from certain unstriped muscle elcments in the wall of the womb.
 
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The tumours are usually multiple and are most commonly found in single women or married women who have never had children. They may grow to any size, and have been known to weigh 100 Ib. They rarely develop before twenty-eight years of ag, but are oceasionally found in much younger women. After the menopause they usually shrink and atrophy, but, on the other hand, they may at this time grow rapidly, which often indicates to malignant changes taking place in the tumour.
A fibroid is surrounded by a capsule and can be shelled out of the wall of the womb, leaving a distinct cavity. If the tumour is cut across is it is found to have a dead white surface, and to be composed of whorls of connective tissue. It has been stated that the use of contraceptives may lead to such tumours, but there is no evidence to support the supposition.
The commonest symptoms are excessive loss at the monthly period, swelling and increase in size of the abdomen, vaginal discharge and pelvic pain. If complications occur, continuous bleeding may result as well as exccssive loss at the periods. Difficulty with the functions of the bowel and bladder due to the pressure of the tumour is also common.
The tumour may undergo various forms of degeneration, the most important of which is malignant degeneration (a form of cancer).
This is most prone to occur at the change of life. Fibroids predispose to sterility.
Small symptomless fibroids require no active treatment. If causing symptoms, removal of the tumour by shelling it out of the womb is the best treatment during the fertile period of lifc. The operation is a safe one, and leavcs the functions of the genital organs unimpaired. In diffuse fibroid enlargement of the womb the whole body of the uterus must be removed.
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